Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Healthcare Reform in the U.S.

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The United States is the only wealthy, industrialized country that does not ensure that all of its citizens have healthcare coverage. Insuring America's Health: Principles and Recommendations, Institute of Medicine at the National Academies of Science, January 14, 2004, last accessed Tuesday, February 2, 2010

"Health Care" and "Insurance Companies"--Oxymoron

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"I don't understand why health care and insurance companies keep appearing in the same sentences." (Fisher, W. Truthout 10/25/09) Isn't it frustrating to have to live under employment based health care insurance?  If you lose your job, your employer wants to cut back, or you are a peasant, you're screwed!  Also, as a result of the way we are paid and the insurance model itself, there are many forces today that steal us away from the exam table or bedside.

Med School Doesn't Teach This

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What new docs need to know and never learned in medical or osteopathic school Harvard Medical School's Top Health Headlines of 2015 as reported in HEALTHbeat, on Twitter, and in their blog. (To read any of these articles or patient education pieces, please go to their website: www.health.harvard.edu/ and/or get a free subscription by registering there.)   Top 5 HEALTHbeat articles How stretching keeps your joints moving Exercise: An effective prescription for joint pain

Heart's Not Healthy? Recouping Tips

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When it comes to health, the better-informed patient does better—Duh! What is a patient to do to reverse or ameliorate heart failure, that is, besides taking meds? ABSTRACT failed to work 5/27/16]pan> Context Little is known about the effects of low health literacy among patients with heart failure, a condition that requires self-management and frequent interactions with the health care system.

Antibiotics, Sensible Use; Injudicious Overuse

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It's easier to prescribe antibiotics in a cold, sinsitis or bronchitis than to explain why not. (It takes less time, it's expected, it's someone else's money and diagnostic confusion from partial or inappropriate treatment will likely be someone else's problem.) Advisory

Reducing Dx Errors

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It's vital to address safety concerns in primary care, especially that which comes from diagnostic errors (i.e., missed, delayed, or incorrect diagnoses). Diagnostic errors are unfortunately all too frequent and they are the largest contributor to "ambulatory malpractice claims (40% in some studies)"; they "cost approximately $300 000 per claim on average."   

If/When Reform Fails to Reform

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The editorial, "If Reform Fails," says the status quo of health care reform is immoral, impractical and unsustainable. What did we expect when the House approved "Health Overhaul, Sending Landmark Bill to Obama"?  Nothing!

Battling Cancer Beyond Everything

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It is crazy to deny terminal patients access to possibly life-saving drugs for fear of offending the Statistics gods! Whether for-profit or not, insurance companies and the pharmaceutical industries are weighing in on experimental therapies; we have to be sure that reasonable  interventions are given a reasonable chance, and that reasonable costs can be factored in. Quoting my wife who is a two-time cancer survivor and advocate:

Getting More Value from Visits

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Be careful! 'What you sow, is what you reap.' A health plan's primary responsibility is ?? (should be the patients they insure).  But, they have policies that "restrain prescription medication spending by shifting costs toward patients. It is unknown how these policies have affected children with chronic illness."  Here's research that proves that cost control may not be about managing care--worse, it can adversely affect your health.

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